
Flex spending accounts can be a great way to save money on medical expenses, but understanding how they work can be confusing. Contributions to a flex spending account are made before taxes, which can reduce your taxable income.
To contribute to a flex spending account, you'll need to have a job that offers this benefit. Many employers offer flex spending accounts as part of their benefits package, but some may not.
What Is an FSA?
An FSA, or Flexible Spending Arrangement, is a tax-free savings account for medical and certain nonmedical expenses. The money in the FSA account can be used to pay qualifying expenses for the taxpayer, their spouse, and their dependents.
FSAs are set up by an employer in a "cafeteria" plan, where the employer provides certain benefits on a pretax basis. This means you won't have to pay income tax on the money you contribute to your FSA.
A unique perspective: For a Firm That Must Pay Income Taxes Depreciation Expense
The FSA is a "use it or lose it" account, which means you have to use the money in your account by the end of the year or you'll lose it. This can be a bit tricky, so be sure to keep track of your expenses and use your FSA funds wisely.
You might like: Flex Spending Account Use It or Lose It
FSA Overview
Flex spending accounts (FSAs) are a type of account that allows you to set aside pre-tax dollars for medical or dependent care expenses. You can contribute up to $3,200 in 2024 ($3,300 in 2025) to an FSA, which can help reduce your tax bill.
To be eligible for an FSA, you need to have an employer that offers this benefit, and you must be a benefit-eligible employee. Self-employed individuals are not eligible for FSAs. Once you select a contribution amount for the year, you cannot change it.
FSAs are administered by your employer or a third-party administrator, and you can use the funds to pay for a wide range of medical expenses, including doctor visits, prescriptions, and medical equipment. You can also use FSA funds for dependent care expenses, such as daycare or elder care.
Additional reading: Health Savings Accounts Eligible Expenses

Here are some examples of eligible expenses for FSAs:
- Doctor visits
- Prescriptions
- Medical equipment
- Dental appointments
- Chiropractors
- Eyeglasses
- Contacts
- Hearing aids
- Addiction treatments
- Modifications to your car or home if you or a family member have a disability
- Ambulance services
- Books and magazines printed in braille
- Some transportation costs related to healthcare treatments
- Training and care of a guide dog
Note that FSAs have some restrictions and limitations, such as not being able to use funds for health insurance premiums or over-the-counter medications. You can find a complete list of eligible expenses in IRS Publication 502.
The tax benefits of FSAs are significant, as the contributions are not subject to federal income tax, Social Security tax, or Medicare tax. You can withdraw the funds tax-free if you use them to pay qualifying expenses.
A different take: Can I Use My Flex Spending Account for Gym Membership
Setting Up and Using an FSA
You can use your FSA to pay for medical expenses by scheduling elective procedures at the beginning of the year. This essentially allows you to take a loan from your employer, which you can repay with pretax dollars.
To set up your FSA, you'll need to contact your plan administrator for help with getting reimbursed. You might also need to submit paperwork and wait for reimbursement.
Certain FSAs allow you to use your total annual contributed funds on the first day for yourself, but only the actual amount in the account for dependents. This means you can take advantage of a better than 0% interest rate by repaying the loan with pretax money.
If this caught your attention, see: Citi Loan Flex Account
How to Use My Account for Expenses

Using your FSA for expenses is a straightforward process. You can use a debit card to withdraw money, but you might need to submit paperwork and wait for reimbursement.
You'll want to keep receipts and any paperwork from doctors, specialists, or for any medical supplies, as you'll need this information to get reimbursed.
Contact your plan administrator for help with getting reimbursed from your Flexible Spending Arrangement.
You can only use FSA funds on approved items, which are listed in the IRS Publication 502. Here are some examples of approved expenses:
- Dental appointments
- Chiropractors
- Eyeglasses
- Contacts
- Hearing aids
- Addiction treatments
- Modifications to your car or home if you or a family member have a disability
- Ambulance services
- Books and magazines printed in braille
- Some transportation costs related to health care treatments
- Training and care of a guide dog
Remember, you can only use FSA funds on these approved items, so be sure to check the list before making a large medical purchase.
How Is My Paycheck Deduction Calculated?
You tell your employer how much you'd like to contribute to your flexible spending account (FSA) in the course of a year. Then, they'll divide that amount by the number of paychecks you'll get and deduct that amount from each paycheck.
Your employer will place your contributions into your FSA. They'll do this on a regular basis, usually through payroll deductions.
The amount deducted from each paycheck will depend on how much you want to contribute to your FSA and how often you get paid.
Explore further: Can a Beneficiary Contribute to Their Own Able Account
Don't Underfund Account
FSAs are typically a use-it-or-lose-it type of plan, so it's essential to contribute enough to cover your medical expenses. You have roughly one year to use the total sum contributed to the plan, or it becomes your employer's money.
In 2024, employers can carry over up to $640 of unused FSA funds, while in 2025, the limit increases to $660. Additionally, employers can offer employees a grace period of up to 2½ months to use any leftover money.
You can't assume you'll spend less than expected, so it's better to contribute more than you think you'll need. Kevin Haney of ASK Benefit Solutions suggests that even if you leave 20% of your contribution unspent, you'll still save $176.
To make the most of your FSA, consider the following:
FSA Contributions and Limits
FSAs are set up by “plan years,” meaning you choose your contribution amount before the new plan year starts. Your employer will then deduct a set amount per pay period.

The contribution limit is $3,200 for 2024, a $150 increase to the contribution limit for these accounts. This limit applies to the amount you can contribute, but there's no limit on how much your employer can contribute.
You can withdraw money tax-free if it's used to pay qualifying expenses, making the most of your FSA contributions.
You might like: 457 Dc Plan
FSA and Other Accounts
You can contribute up to $3,300 per year to a Health Care FSA, which can be used to pay for eligible medical, dental, and vision expenses. This account allows you to set aside pre-tax dollars to help pay for these expenses.
The District offers two types of FSAs: the Health Care Flexible Spending Account and the Dependent Care Flexible Spending Account. These pre-tax accounts allow you to pay for eligible, out-of-pocket health and/or dependent care expenses.
You can use your FSA debit card to pay for eligible expenses, or submit claims for reimbursement through the HSA Bank member website. Keep your receipts to submit with your claims, and be sure to file claims by March 31 of the following year.
Here are some eligible expenses you can pay with your FSA:
- Copayments and deductibles
- Prescription drugs
- Hospital charges
- Medical equipment
- Lab fees
- Hearing exams and hearing aids
- Dental exams and dental work
- Orthodontia
- Eye exams
- Prescription glasses and sunglasses
- Contact lenses and contact lens solution
- LASIK or other eye surgery
- Insulin and diabetes testing supplies
- First-aid supplies
- Over-the-counter medications without a prescription
- Menstrual products
Health Insurance Not Required

You can set aside pre-tax dollars to help pay for eligible medical expenses, even if you don't have health insurance. This is made possible through a Health Care Flexible Spending Arrangement, or HCFSA.
You can contribute up to $3,300 every year through paycheck deductions that reduce your taxable income. Your annual contribution total is available for you to use on January 1.
Some eligible expenses you can pay with your HCFSA include copayments, deductibles, prescription drugs, hospital charges, and medical equipment. You can also use it for dental exams, eye exams, and hearing exams.
Here are some examples of eligible expenses:
- Copayments and deductibles
- Prescription drugs
- Hospital charges
- Medical equipment
- Lab fees
- Hearing exams and hearing aids
- Dental exams and dental work
- Orthodontia
- Eye exams
- Prescription glasses and sunglasses
- Contact lenses and contact lens solution
- LASIK or other eye surgery
- Insulin and diabetes testing supplies
- First-aid supplies
- Over-the-counter medications without a prescription
- Menstrual products
You can find a complete list of eligible Health Care FSA expenses in IRS Publication 502, Medical and Dental Expenses.
For your interest: Can I Write off Business Expenses on My Personal Taxes
HSA vs FSA: Which to Choose?
If you have an HSA, you're not limited to just one option for a health savings plan. You're eligible for a limited health FSA, which covers only dental and vision expenses.

This limited FSA allows you to contribute to both an HSA and a limited health FSA, maximizing your tax deductions and savings. You can contribute the maximum amounts for both accounts.
You can't have a regular health FSA if you have an HSA, but this limited option gives you flexibility.
HSA
An HSA is a great way to save for medical expenses, and it's even more flexible than an FSA. You can contribute up to $4,150 for an individual and $8,300 for a family in the 2024 tax year, with higher limits of $4,300 and $8,550 in 2025.
One of the biggest advantages of an HSA is that the money stays in your account to use in the future, even if you leave your job or retire. This means you don't have to worry about losing your contributions if you switch employers.
You can only have an HSA if you also have a high-deductible health plan, which has a deductible of $1,600 or higher for self-coverage or $3,200 or higher for family coverage in 2024. In 2025, this will increase to $1,650 for self-coverage or $3,300 for family coverage.
HSAs have no use it or lose it rule, so you can keep your contributions even if you don't use them all in the same year. This makes them a great option if you're self-employed or have variable medical expenses.
You might like: Coinsurance after Deductable
Limited Purpose

Limited Purpose FSA (LPFSA) offers an additional pre-tax contribution option for health expenses, allowing you to set aside up to $3,300 per year.
You can contribute from $260 to $3,300 per year to your LPFSA, and your contributions are deducted from your paycheck pre-tax, in equal amounts throughout the year.
The money in your LPFSA is available for use on January 1, and you can use it to cover qualified dental and vision expenses, including your share of expenses for dental work and prescription glasses.
You can find a complete list of eligible LPFSA dental and vision expenses in IRS Publication 502, Medical and Dental Expenses.
To use your LPFSA for medical expenses, you must meet your medical plan's deductible, and you can file a claim for reimbursement by submitting a Post-Deductible Expense Reimbursement Certification Form along with a copy of an Anthem Explanation of Benefits (EOB).
Here are the key details to keep in mind when using your LPFSA:
- Contribution limits: $260-$3,300 per year
- Contributions are deducted pre-tax from your paycheck
- Money is available for use on January 1
- Eligible expenses include dental work, prescription glasses, and medical expenses after meeting your deductible
- Claims must be submitted by March 31 of the following year
FSA Disadvantages and Quitting

If you quit your job, you'll lose your FSA funds if you don't use them before you go. You can't roll over the funds to the next year, so it's essential to use as much of your FSA account as possible before leaving your employer.
Erik O. Klumpp, a financial advisor, recommends utilizing as much of your FSA account as you can before quitting. This way, you won't forfeit the excess money in your account, which your employer gets to keep.
Here are some key facts to keep in mind:
You'll also forfeit your funds if you leave your job without using them, so it's crucial to plan ahead and use your FSA wisely.
FSA Loans and Repayment
You can use your FSA as a loan for elective procedures, scheduling them at the beginning of the year to essentially take a loan from your employer.
If you use your FSA funds for dependents, you can only use the actual amount in the account, not your total annual contributed funds.
Here's an interesting read: What Is a Loan Receivable Account

Employers must immediately fund any qualified expense, regardless of when it occurs during the plan year. This means you have 52 weeks to repay the loan using pretax dollars.
Repaying the loan with pretax dollars gives you a better than 0% interest rate, as you're essentially saving on taxes. For example, if you'd need to earn $1,603 in gross income to have $1,000 in after-tax dollars, that's a minus 60% interest rate.
Quitting your job before using your FSA funds means your employer gets to keep the money.
FSA Eligibility and Requirements
To be eligible for a Health Care FSA, you can contribute up to $3,300 every year through paycheck deductions that reduce your taxable income.
You can contribute from $260 to $3,300 per year, with contributions deducted from your paycheck pre-tax and deposited in your HCFSA.
The annual contribution total is available for you to use on January 1, so you can plan ahead and make the most of your FSA.
You can access your HSA Bank accounts directly through HSA Bank's member website at myaccounts.hsabank.com, where you can submit claims for reimbursement and confirm your expenses.
Here are some of the expenses you can pay with your HCFSA:
You have until March 31 of the following year to file claims for expenses incurred in the current year, so be sure to keep track of your receipts and submit your claims on time.
Who Is Eligible?
You can be eligible for a health FSA even if you don't have health insurance, but you do need to be an employee of an employer who offers one.
To be eligible for an FSA, you must be an employee of an employer who offers an FSA.
Consider reading: Cigna Flex Spending Account Eligible Items
Requirements for Dependent Care
To be eligible for a Dependent Care FSA, you or your spouse must work or be looking for work. The child for whom the expenses were paid must be under 13 years old, unless they have a disability that makes them unable to care for themselves.
Recommended read: Daycare Flex Spending Account
If your child turns 13 during the plan year, any childcare expenses after their birthday are ineligible. However, if you have a child or other dependent relative over age 13 who is mentally or physically incapable of caring for themselves, your Dependent Care FSA can be used to pay for expenses.
You can contribute up to $5,000 per household or $2,500 if married and filing separately to a Dependent Care FSA.
Here are the key requirements for a Dependent Care FSA:
- Both you and your spouse must work or your spouse must be a full-time student.
- You must be the custodial parent or guardian.
- The dependent must live with you for the majority of the year.
You can find a complete list of eligible Dependent Daycare FSA expenses in IRS Publication 503, Child and Dependent Day Care Expenses.
FSA Key Information
An FSA is only accessible through an employer, so if you're self-employed, you're out of luck.
You can contribute up to $3,200 in 2024 ($3,300 in 2025) to an FSA, which is deducted from your gross income before taxes. This can significantly reduce your taxable income for the year.
To get an FSA, you typically sign up during your company's open enrollment period, usually in November or December. You can only choose a contribution amount for the year, and you can't change it.
Here are some approved items you can use FSA funds for:
- Dental appointments
- Chiropractors
- Eyeglasses
- Contacts
- Hearing aids
- Addiction treatments
- Modifications to your car or home if you or a family member have a disability
- Ambulance services
- Books and magazines printed in braille
- Some transportation costs related to health care treatments
- Training and care of a guide dog
Key Takeaways
A flexible spending account (FSA) is a great way to save on health care costs. You can use pretax dollars to pay for medical expenses, including prescriptions, eyeglasses, and dental appointments.
FSAs are only available through an employer, so if you're self-employed, you won't be able to get one. This means you'll need to explore other options for saving on health care costs.
One of the best things about FSAs is that you get to choose how much you contribute, which is deducted from your gross pay and reduces your taxable income for the year. This can be a huge advantage if you have high medical expenses.
Discover more: Do You Have to Pay Taxes on Grants for Business
FSA funds can be used for a variety of medical expenses, including dependent and disability care. This can be a big help if you have a family or are caring for a loved one.
A Health Savings Account (HSA) is similar to an FSA, but it has slightly different processes and contribution limits. If you're considering an HSA, be sure to do your research and understand the differences.
Consider reading: Difference between Flex Spending Account and Hsa
The Bottom Line
If you're not participating in an FSA, you're essentially throwing away a 30% discount on health care costs. This is a significant savings opportunity that's hard to ignore.
The key is to understand how FSAs work and what benefits they offer. A flexible spending account allows employees to pay for health care costs with pretax dollars, which reduces taxable income for that year.
By contributing to an FSA, you can save a substantial amount on taxes. In fact, amounts contributed are not subject to federal income tax, Social Security tax, or Medicare tax. This can add up to a significant reduction in your income tax.

If you have a spouse with a plan through their employer, you can both contribute to an FSA. In this case, the couple can jointly contribute up to $6,400 for their household, as long as the plan allows it.
To give you a better idea, here's a breakdown of the tax benefits of an FSA:
So, what's the bottom line? By participating in an FSA, you can save a significant amount on taxes and reduce your income tax. It's a useful way to cover expensive health care costs while also getting tax savings.
FSA Miscellaneous
You can contribute up to $5,000 to an FSA, but some plans may allow for a higher contribution limit.
If you're married, you and your spouse can contribute to an FSA, with a combined limit of up to $6,400 for your household.
Employers can also contribute to an FSA, but this is optional and not required.
To withdraw money from an FSA, you'll need to use it to pay for qualifying expenses, and then you can withdraw the money tax-free.
Frequently Asked Questions
How do I report a flexible spending account on my taxes?
You don't report flexible spending account contributions as a deduction on your tax return, but they may appear in Box 14 of your W-2 for informational purposes. Check with your employer to verify the details.
What are the IRS rules regarding FSA accounts?
According to IRS rules, FSA contributions are tax-free, exempt from federal income tax, Social Security tax, and Medicare tax, with a maximum annual contribution limit of $3,300 in 2025. Employer contributions may also be allowed, depending on the plan.
Sources
- https://learn.hellofurther.com/Employers/Group_Administration/FSA_and_DCAP_Payroll_Fact_Sheet
- https://benefits.seagate.com/financial/flexible-spending-accounts
- https://www.investopedia.com/articles/personal-finance/060215/how-flexible-spending-accounts-work.asp
- https://www.1040.com/tax-guide/health-and-life-insurance/fsas-and-your-tax-return/
- https://dds.dc.gov/page/flexible-spending-accounts
Featured Images: pexels.com